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Individual

MRS. STEPHANIE T BENGALI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
75 TURNPIKE RD, IPSWICH, MA 01938-1046
(978) 356-0315
Mailing address
75 TURNPIKE RD UNIT 3C, IPSWICH, MA 01938-1046

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10639
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10639
COMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE
MA
01
295425
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
Enumeration date
02/07/2018
Last updated
03/17/2018
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